Page 7 - TPA Journal November December 2022
P. 7
REGISTRATION FORM
Police & Fire Civil Service Act
Chapter 143, Local Government Code
Sheraton Austin Georgetown Hotel
Georgetown, Texas
December 13, 2022
Name:
1. Title:
(Please Print)
TCOLE ID# Email:
2. Title:
TCOLE ID# Email:
3. Title:
TCOLE ID# Email:
Name of Agency/Organization:
Address:
Street or Box City Zip
Phone: E-Mail
TPA Member Registration ----------------------------------------------------------$150.00
Non-TPA Member Registration----------------------------------------------------$200.00
Total Amount Enclosed--------------------------------------------------$
Return to: Texas Police Association No refunds, replacements welcome.
P. O. Box 4247
Austin, TX 78765-4247 Invoicing is available upon request.
(512) 458-3140
Or Email to: mona@texaspoliceassociation.com
American Express Discover MasterCard Visa
Name (on card):
Card Number: Exp. Date: Sec. Code
Signature: Today’s Date:
CASH CHECK/MONEY ORDER
**Credit Card Fees will be passed along to Registrant.**
